CPT code 45915: Rectal obstruction removal, under anesthesia2026 Medicare rate & RVUs in New Hampshire

Report this service when a clinician removes obstructing stool or a foreign body from the rectum under anesthesia.

CMS RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In New Hampshire, Medicare pays $412.33 for 45915 in the office and $233.61 when it’s performed in a hospital or facility.

$412.33Office (non-facility)
$233.61Hospital or facility
+2.2%vs the national office rate ($403.48)

Check a contract rate as a % of Medicare · 45915 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 45915 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Hampshire
  2. What 45915 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 45915 covers

This service covers removal of obstructing material from the rectum when the work is performed under anesthesia. Typical cases include a substantial fecal impaction or a rectal foreign body that requires procedural extraction rather than routine office or bedside care. Colorectal and general surgeons commonly perform it in a hospital or ambulatory surgical setting; the clinical record should identify the obstruction and describe the removal performed.

Select the code for the extraction itself, not for treatment of a narrowing, sphincter problem, or prolapse that may cause obstructive symptoms. Document the material removed, the anatomic site, the technique, and the use of anesthesia. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How New Hampshire compares for 45915

Across 109 of 109 payment localities, the office rate for 45915 runs from $354.11 in Arkansas to $528.57 in San Benito County, CA. New Hampshire pays $412.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

45915 in New Hampshire vs other payment areas
  1. New Hampshire · this page$412.33
  2. Los Angeles, CA · California$451.82+$39.49
  3. Washington, DC area · District of Columbia$461.08+$48.75
  4. Miami, FL · Florida$446.58+$34.25
  5. Chicago, IL · Illinois$432.42+$20.09
  6. Manhattan, NY · New York$467.45+$55.12
  7. Alaska · Alaska$464.25+$51.92

Other areas in New Hampshire first, then benchmark localities. Bars start at $0.

Every other payment area

45915 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$359.63$209.41
ArkansasArkansas$354.11$206.64
ArizonaArizona$391.86$225.50
Bakersfield, CACalifornia$424.13$235.97
Chico, CACalifornia$422.41$234.25
El Centro, CACalifornia$422.52$234.36
Fresno, CACalifornia$422.41$234.25
Hanford, CACalifornia$422.41$234.25

45915 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$354.11

$475.49

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
45915 office rate range by state
State / territoryOffice rate rangeLocalities
AK$464.251
AL$359.631
AR$354.111
AZ$391.861
CA$422.41–$528.5729
CO$418.041
CT$431.381
DC$461.081
DE$398.561
FL$401.63–$446.583
GA$377.34–$412.422
GU$432.971
HI$432.971
IA$367.291
ID$370.261
IL$390.88–$432.424
IN$372.481
KS$366.441
KY$370.771
LA$370.54–$389.842
MA$415.72–$459.572
MD$406.17–$461.083
ME$373.34–$393.332
MI$381.89–$407.932
MN$396.991
MO$364.46–$390.143
MS$359.311
MT$403.441
NC$377.321
ND$391.181
NE$369.131
NH$412.331
NJ$435.31–$456.062
NM$384.501
NV$400.301
NY$383.39–$480.595
OH$379.381
OK$369.021
OR$396.22–$430.802
PA$379.47–$420.782
PR$406.241
RI$412.421
SC$379.181
SD$389.731
TN$368.521
TX$376.91–$417.518
UT$384.641
VA$392.65–$461.082
VI$406.241
VT$390.461
WA$414.67–$468.202
WI$377.441
WV$375.871
WY$398.101

See 45915 in every payment locality

How the 45915 rate is calculated

Each of 45915’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 45915

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.11

3.11 RVUs× 1.000 GPCI

Practice expense8.35

8.35 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

12.0800

Conversion factor

$33.4009

Medicare rate

$403.48

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Hampshire inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,567

Code
45915
Physician work
3.11
Practice expense
8.35
Malpractice
0.62

GPCI2026.csv

74

Locality
New Hampshire
Physician work
1.000
Practice expense
1.041
Malpractice
0.875
Office calculation for 45915 in New Hampshire
ComponentRVULocality factorAdjusted
Physician work3.11× 1.0003.1100
Practice expense8.35× 1.0418.6923
Malpractice0.62× 0.8750.5425
Total RVUs12.3448
Conversion factor× 33.4009

Office rate, New Hampshire$412.33

Office: (3.11 × 1 + 8.35 × 1.041 + 0.62 × 0.875) × $33.4009 = $412.33

Facility: (3.11 × 1 + 3.21 × 1.041 + 0.62 × 0.875) × $33.4009 = $233.61

Open 45915 in the RVU calculator

Payment rules and modifiers for 45915

45915 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45915

Rectal obstruction removal, under anesthesia

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 45915

Rectal obstruction removal, under anesthesia

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45915 without 51 · national office

$403.48

Rectal obstruction removal, under anesthesia

45915-51 · Second procedure: 50%

$201.74

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 45915 has changed in New Hampshire

45915 · Office / nonfacility

$412.33

Effective 2026-10-01

The base rate is $60.94 higher than on 2025-10-01, moving from $351.39 to $412.33 (17.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $351.39changed to$412.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.19 changed to 3.11
    • Practice expense RVU 6.90 changed to 8.35
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 1.034 changed to 1.041
    • Malpractice GPCI 0.898 changed to 0.875

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $359.55changed to$351.39

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.84 changed to 6.90

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $353.68changed to$359.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $366.06changed to$353.68

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.58 changed to 0.60
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 0.907 changed to 0.898
  5. January 1, 2023

    RVU23A

    $377.06changed to$366.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.92 changed to 6.84
    • Malpractice RVU 0.57 changed to 0.58
    • Practice expense GPCI 1.038 changed to 1.036
    • Malpractice GPCI 0.917 changed to 0.907

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $378.78changed to$377.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.89 changed to 6.92
    • Malpractice RVU 0.56 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $366.33changed to$378.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.17 changed to 6.89
    • Malpractice RVU 0.54 changed to 0.56
    • Practice expense GPCI 1.042 changed to 1.038
    • Malpractice GPCI 0.984 changed to 0.917

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $360.23changed to$366.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.00 changed to 6.17
    • Malpractice RVU 0.51 changed to 0.54
    • Practice expense GPCI 1.045 changed to 1.042
    • Malpractice GPCI 1.050 changed to 0.984

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $356.07changed to$360.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.91 changed to 6.00
    • Malpractice RVU 0.50 changed to 0.51

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $350.38changed to$356.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.80 changed to 5.91
    • Malpractice RVU 0.49 changed to 0.50
    • Practice expense GPCI 1.052 changed to 1.045
    • Malpractice GPCI 0.962 changed to 1.050

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $349.17changed to$350.38

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.79 changed to 5.80
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.058 changed to 1.052
    • Malpractice GPCI 0.873 changed to 0.962

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $350.88changed to$349.17

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.81 changed to 5.79
    • Malpractice RVU 0.49 changed to 0.50

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $349.14changed to$350.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $342.53changed to$349.14

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.65 changed to 5.81
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.051 changed to 1.058
    • Malpractice GPCI 0.867 changed to 0.873

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$342.53

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$412.33$233.61RVU26D
2026-07-01$412.33$233.61RVU26C
2026-04-01$412.33$233.61RVU26B
2026-01-01$412.33$233.61RVU26A
2025-10-01$351.39$226.97RVU25D
2025-07-01$351.39$226.97RVU25C
2025-04-01$351.39$226.97RVU25B
2025-01-01$351.39$226.97RVU25A
2024-10-01$359.55$230.82RVU24D
2024-07-01$359.55$230.82RVU24C
2024-04-01$359.55$230.82RVU24B
2024-03-09$359.55$230.82RVU24AR
2024-01-01$353.68$227.05RVU24A
2023-10-01$366.06$234.41RVU23D
2023-07-01$366.06$234.41RVU23C
2023-04-01$366.06$234.41RVU23B
2023-01-01$366.06$234.41RVU23A
2022-10-01$377.06$239.48RVU22D
2022-07-01$377.06$239.48RVU22C
2022-04-01$377.06$239.48RVU22B
2022-01-01$377.06$239.48RVU22A
2021-10-01$378.78$240.78RVU21D
2021-07-01$378.78$240.78RVU21C
2021-04-01$378.78$240.78RVU21B
2021-01-01$378.78$240.78RVU21A
2020-10-01$366.33$244.11RVU20D
2020-07-01$366.33$244.11RVU20C
2020-04-01$366.33$244.11RVU20B
2020-01-01$366.33$244.11RVU20A
2019-10-01$360.23$243.10RVU19D
2019-07-01$360.23$243.10RVU19C
2019-04-01$360.23$243.10RVU19B
2019-01-01$360.23$243.10RVU19A
2018-10-01$356.07$242.08RVU18D
2018-07-01$356.07$242.08RVU18C
2018-04-01$356.07$242.08RVU18B
2018-01-01$356.07$242.08RVU18AR1
2017-10-01$350.38$239.38RVU17D
2017-07-01$350.38$239.38RVU17C
2017-04-01$350.38$239.38RVU17B
2017-01-01$350.38$239.38RVU17A
2016-10-01$349.17$237.43RVU16D
2016-07-01$349.17$237.43RVU16C
2016-04-01$349.17$237.43RVU16B
2016-01-01$349.17$237.43RVU16A
2015-10-01$350.88$239.11RVU15D
2015-07-01$350.88$239.11RVU15C
2015-04-01$349.14$237.92RVU15B
2015-01-01$349.14$237.92RVU15A
2014-10-01$342.53$234.47RVU14D
2014-07-01$342.53$234.47RVU14C
2014-04-01$342.53$234.47RVU14B
2014-01-01$342.53$234.47RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 45915 for an earlier date of service

Where the New Hampshire rate applies

New Hampshire is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in New Hampshire. Some span more than one payment area; confirm with the service ZIP.

  • Alton
  • Amherst
  • Antrim
  • Ashland
  • Bartlett
  • Belmont
  • Bennington
  • Berlin

Browse all communities in New Hampshire

45915 billing questions

When should this code be chosen instead of rectal dilation?

Use this code when the service removes obstructing material from the rectum. Code 45910 describes dilation of a rectal narrowing, rather than extraction.

Does the code include anesthesia?

The service is defined as being performed under anesthesia. Document the anesthesia and the extraction performed; this code does not represent a separately reported anesthesia service.

Can modifier 50 be used?

No. The code’s descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Related postoperative visits during the 10-day global period are included.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 45915PPRRVU2026_Oct_nonQPP.csv, line 5,567 (RVU26D)
Geographic factors for New HampshireGPCI2026.csv, line 74 (RVU26D)

Open CMS sourceHow we calculate rates

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